Music Interventions for Disorders of Consciousness: A Systematic Review and Meta-analysis

Quantitative evidence for the effects of music on patients with disorders of consciousness (DOCs) was presented. This study was based on available studies to summarize the effect estimates of music for DOC patients.

Three electronic databases were searched for studies that investigated the effects of music for DOC patients from start to July 2018. The summary results included functional scale, general physical indexes, electroencephalogram indexes, and favorable outcomes. The weighted mean difference and odds ratio with a corresponding 95% confidence interval were used to calculate continuous and frequency data using a random-effects model. This report adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Randomized controlled trials (3) and cohort studies (8) involving 201 DOC patients were included. Patients with DOCs receiving music interventions were associated with high levels of California Verbal Learning Test (P = .038) and persistent vegetative state (P < .001), whereas no significant differences were detected for agitated behavior scale (P = .982), Glasgow Coma Scale (P = .216), Mini-Mental State Examination (P = .215), music therapy in a vegetative or minimally conscious state (P = .590), and Stroop (P = 1.000). Furthermore, DOC patients receiving music intervention showed a significantly increased facial expression (P = .003) and reduced systolic blood pressure (P = .036), whereas no significant effects were observed on diastolic blood pressure (P = .777), heart rate (P = .666), oxygen saturation (P = .911), pulse (P = .899), respiratory frequency (P = .427), and temperature (P = .864). Moreover, music did not contribute significantly to electroencephalogram indexes including alpha (α), beta (β), delta (δ), and theta (θ) in the left and right hemispheres (P > .050). Finally, DOC patients receiving music intervention showed an increased incidence of favorable outcomes (P = .015).

This quantitative meta-analysis indicated that music might play a critical role on the functional scale, general physical indexes, and favorable outcomes for DOC patients. Music therapy can easily be provided at the bedside by nurses working with DOC patients.